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05 February 2010

Diabetes and adolescents

Most teenagers who are diabetic have type 1 diabetes, but worldwide, doctors are alarmed by the increase of type 2 diabetes amongst younger and younger people.

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Most teenagers who are diabetic have type 1 diabetes, but worldwide, doctors are alarmed by the increase of type 2 diabetes amongst younger and younger people.

Adolescence is a difficult age – children’s bodies undergo massive hormonal changes and they experience mood swings and often problems with identity – all quite understandable in this difficult phase of transition.

Throw in diabetes, and things could become very difficult indeed for everyone concerned.

“Fitting in with your peer group is very important during puberty,” says Prof Francois Bonnici of the Endocrine-Diabetis Unit at the UCT Medical School, “and being diabetic sets a child apart from peers to an extent. They cannot always take part in the same activities, go to all-night parties, and experiment with all sorts of things like other teenagers do.”

“Furthermore, the hormonal surge happening in their bodies plays havoc with their insulin levels – an adolescent boy could need three times the normal dosage of insulin in order to regulate his blood sugar levels. In a non-diabetic boy, his pancreas will produce three times as much insulin as usual, but in a diabetic teenager this increased demand can wreak havoc with insulin and glucose control.

There is a general perception that diabetic adolescents are difficult to treat, because they do not always stick to their medication. But this is by no means always so.”

“One must primarily see a diabetic adolescent as an adolescent first and then a diabetic. There are many sacrifices diabetic children have to make and this is the age at which they start questioning which ones are worth it.”

“The tricky thing is that this is also the age at which many parents have to start standing back and letting their child assume responsibility for their glucose testing and regular insulin injections.”

“It is important that parents and doctors do not put too much stress on perfection. Alienating a child for not sticking to the exact regimen is unwise. Diabetes is a difficult disease to cope with, all the more so if you have the added vagaries of adolescence. Parents and doctors should not call a child ‘good’ or ‘bad’ based on their medication history. One should rather speak of diabetes that is ‘well-controlled’ or ‘not-so-well-controlled.”

Tips on dealing with adolescents who have diabetes

Joint responsibility

A parent who takes full responsibility for managing diabetes in their teenager, is carrying an unnecessarily large burden. This responsibility should be shared – a 15-year-old is quite capable of taking control of his or her treatment and it is time for a parent to back off and to show interest rather than to interfere directly.

Inform the school

Teachers at the school should be on the lookout for symptoms of both hypoglycaemia and hyperglycaemia. There should also be teachers on the premises who know how to administer the medication.

Keep lines of communication open

Your child is going through a difficult time. During adolescence communication becomes even more difficult. Be prepared to listen, not to pry and also to hear things which might not make you very happy. If talking is difficult, write a letter. Your child must know that he/she can trust you. Back off sometimes when things are not working. Sometimes everyone needs time out.

Don’t strive for perfection

Pushing for 100 percent adherence to the diabetes diet and testing procedures will cause unnecessary stress for both of you. 90 percent is enough. Don’t alienate your child by making them feel like failures.

Keep it between you

Don’t discuss the whole issue in front of friends. Let your child decide when and whom they would like to tell. Your child does not want to feel different from other children. Create the opportunity for them to fit in.

Phone support

Get your child to join a support group for adolescent diabetics. With a bit of luck he or she will make friends there. In difficult times, these friends’ support could be invaluable, as they have been there themselves and know why things can get difficult.

Don’t play the angel of doom

Your child has a pretty good idea of what could happen if rules are broken and medication is not taken regularly. An occasional reminder can be given, but harping on this constantly could actually alienate your child and make them not comply in order to get at you. The message that you are also giving when you do this, is that you have chosen to take full responsibility for your child’s condition. - (Health24, January 2000)

 
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